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Substitution of doctors by nurses in Primary Care

  • Protocol
  • Intervention



This is the protocol for a review and there is no abstract. The objectives are as follows:

To determine the effects of substituting nurses for doctors in primary care.

The following hypotheses will be tested.

Doctor-nurse substitution in primary care has no impact on:
1. Patient health outcomes (eg morbidity, mortality, patient satisfaction, quality of life);
2. Process of care (eg patient compliance, standards of care);
3. Health care resource utilisation (eg frequency and length of consultations, number of return visits, prescriptions, tests and investigations ordered, referrals, use of emergency and other health services).

Comparison groups will be:
Care provided by nurse versus care provided by primary care physician.

The hypotheses will be tested around three clinical areas: minor illnesses* ; chronic diseases, including asthma, diabetes, hypertension and cardiac care; and health promotion advice to well people including lifestyle, dietary, exercise, smoking and alcohol advice.

* There is no widely agreed definition of minor illness. Health professionals recognise minor illnesses as acute self-limiting non-life threatening illnesses such as upper respiratory tract infections.